# INNOVATIVE HEALTH SYSTEMS

> Is this information incorrect? This page shows public data from NPPES. Update your record in NPPES and this page will update automatically within 7 days. [Update your NPPES record](https://nppes.cms.hhs.gov)

- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1427676436
- **Authorized official:** MR. RICARDO DAVID TILLERY MBA, LCSW, SAP (CEO)
- **Authorized official phone:** (517) 703-3387

## Contact information

- **Practice address:** 3721 W MICHIGAN AVE STE 200, LANSING, MI 48917-3600
- **Practice address phone:** (517) 515-6176
- **Mailing address:** 3721 W MICHIGAN AVE STE 200, LANSING, MI 48917-3600
- **Mailing address phone:** (517) 515-6176

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1041C0700X | Clinical Social Worker | — | NULL | — |
| 1041C0700X | Clinical Social Worker | — | — | — |
| 251B00000X | Case Management Agency | — | NULL | — |
| 251C00000X | Developmentally Disabled Services Day Training Agency | — | NULL | — |
| 251E00000X | Home Health Agency | — | NULL | — |
| 251K00000X | Public Health or Welfare Agency | — | NULL | — |
| 251S00000X | Community/Behavioral Health Agency | — | NULL | — |
| 251T00000X | PACE Provider Organization | — | NULL | — |
| 252Y00000X | Early Intervention Provider Agency | — | NULL | — |
| 253Z00000X | In Home Supportive Care Agency | — | NULL | — |
| 261QA0600X | Adult Day Care Clinic/Center | — | NULL | — |
| 261QC1500X | Community Health Clinic/Center | — | NULL | — |
| 261QC1800X | Corporate Health Clinic/Center | — | NULL | Yes |
| 261QM0850X | Adult Mental Health Clinic/Center | — | NULL | — |
| 324500000X | Substance Abuse Rehabilitation Facility | — | NULL | — |
| 3245S0500X | Children's Substance Abuse Rehabilitation Facility | — | NULL | — |

## Other

- **Enumeration date:** 07/07/2020
- **Last updated:** 07/07/2020